“1 in 4 nurses has been assaulted at work — making nurses more likely to be exposed to violence than either prison guards or police officers. Yet few health care employers have developed suitable plans to prevent workplace violence, putting nurses and others at risk daily, just for doing their job”.
American Nurses Association (ANA) #EndNurseAbuse legislation letter to lawmakers.

While many people think of the healthcare industry as being, clean, sterile and safe from violence, the reality is that workers in this sector are exposed to many hazards that affect their health and well-being. One of such hazards is workplace violence (The National Institute for Occupational Safety and Health [NIOSH], 2009).

NIOSH (1996) defines workplace violence is defined as “violent acts, including physical assaults and threats of assault, directed toward persons at work or on duty”. Workplace violence ranges from threats and verbal abuse to physical assaults and even homicide.

Although workplace violence can occur across all professions and industries, it has reached epidemic levels in the healthcare industry. In the last decade, the rate of violent incidents reported against healthcare workers has increased by 110% (Campbell, 2016). In 2018, health care and social service workers suffered 73% of nearly 21,000 intentional injuries caused by another person (Bureau of Labor Statistics [BLS], 2019). It is worth noting that violent incidents in healthcare are grossly underreported.

Nurses are one group that is particularly affected by violence in healthcare settings. A study revealed that one in four nurses experienced verbal or physical abuse from patients or visitors in 2014 (Speroni et al., 2014). ANA found even more shocking statistics: one in four nurses has been physically assaulted at work.

“I’ve been bitten, kicked, punched, pushed, pinched, shoved, scratched, and spat upon. I have been bullied and called very ugly names. I’ve had my life, the life of my unborn child, and of my other family members threatened, requiring security escort to my car.”
Lisa Tenney, RN, of the Maryland Emergency Nurses Association (The Joint Commission, 2018)

Why are nurses at such high risk of violence?

Surprisingly, it is mostly patients who attack nurses (Speroni, 2014). Why does this happen? Nurses are the on the front lines of healthcare and interact with most patients that come through the door regardless of their physical, emotional or mental condition. When patients present a confused mental state caused by alcohol, drugs, mental illness and other medical conditions, the risk of perpetrating violence dangerously increases. For example, think of someone under the influence of drugs who doesn’t know where he is and when the nurse tries to start an IV line, he attacks her thinking that someone is trying to harm him. Many believe that the opioid epidemic is partly to blame for the spike in violence against nurses and healthcare workers, which could very well be a contributing factor.

Other reasons that contribute to violence against nurses include a culture of “violence comes with the job”, lengthy and cumbersome procedures to report violent incidents, inadequate emergency communication systems and safety protocols, and lack of training on violence prevention.

Enough is enough

Despite the fact that nurses must face the terrifying possibility of becoming victims of workplace violence on a daily basis, currently there are no federal regulations that protects them from the shocking epidemic of violence.

In the past five or so years, nurses across the country have made remarkable efforts to fight against violence in the workplace and demand “zero-tolerance” to violence policies and federal legislation that protects them. ANA has been a notable advocate for this cause. In 2017, ANA launched the End Nurse Abuse initiative to increase awareness of the serious problem of physical and verbal abuse against nurses and convened a professional panel to develop policy and identify strategies to address barriers to nurses and other health care workers reporting violence and abuse.

The HR 1309 Bill

In 2018, a group of House Democrats led by Rep. Joe Courtney, introduced the federal bill- HR 1309, the Workplace Violence Prevention for Health Care and Social Service Workers. In July of 2019 the bill was voted out of the House Committee on Education and Labor and now waits for House leadership to take it to a full House floor vote. If it passes, this bill will represent a great victory for nurses as employers would be held accountable through the federal Occupational Safety Health Administration for having a comprehensive prevention plan in place to stop workplace violence.